- In-patient Care (Hospitalisation)
We cover cost of medical treatment when you or your insured family members are hospitalised for treatment.
- Day care treatments covered
We cover all day care treatments under the product.
We will indemnify the medical expenses incurred on the insured person’s hospitalization for Inpatient Care on treatment taken under Ayurveda, Unani, Siddha and Homeopathy.
- Domiciliary Hospitalisation
In case a bed in the hospital is unavailable or on advice of the attending medical practitioner, treatment is administered at home; we pay for medical treatment taken at home, which would otherwise have required hospitalisation. Such treatment should continue for at least 3 consecutive days and confirmation from treating medical practitioner/insured that insured person could not be transferred to the hospital or hospital bed was unavailable, as the case may be.
We will indemnify the medical expenses incurred on the insured person’s hospitalization for Inpatient Care or as a part of Day Care Treatment for modern treatments like oral chemotherapy, deep brain stimulation, etc. There is a sub-limit of Rs. 1Lac on few robotic surgeries.
No limit on the hospital room rent& ICU charges. They are covered up to Sum Insured.
- Pre & Post Hospitalisation Medical Expenses
We reimburse pre & post hospitalization medical expenses incurred due to illness/injury. The period of the treatment covered is 60 days before you get admitted to the hospital and 180 days after you get discharged from the hospital. This is subject to Niva Bupa accepting the In-patient Care hospitalisation, Day Care, Alternative Treatments or Modern Treatments claim.
Medical expenses for an organ donor’s In-patient treatment for the harvesting of the organ donated is also covered provided the organ is for the use of the insured person.
We also cover the road ambulance expenses to transfer the insured following an emergency to the nearest hospital. We also provide ambulance coverage if the medical condition requires immediate ambulance services from the existing Hospital to another Hospital with advanced facilities for management of the current Hospitalization. These expenses are paid up to Rs2,000 per hospitalization only if we have accepted anIn-patient or Day Care Treatment claim.
We also cover costs incurred for ambulance transportation in an airplane or helicopter, for Emergency life threatening health conditions which require immediate and rapid ambulance transportation to the Hospital / medical centre that ground transportation cannot provide. Air Ambulance is covered up to Sum Insured for Cashless claim & up to Rs. 2.5 Lacs for Reimbursement claim.
We will cover Medical Expenses incurred on the Insured Person’s treatment taken at home for Chemotherapy or Dialysis, if these services are offered by a registered homecare provider.
In case of claim free year, increase of 50% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured (In case of a claim, reduction of accumulated Cumulative Bonus by 50% of expiring Base Sum Insured)
Under this benefit unlimited reinstatements are provided for both same & different illness. It is triggered with the first paid claim itself and is available for all subsequent claims in a Policy Year. The maximum liability under a single claim under this benefit shall not be more than Base Sum Insured.
- Shared accommodation Cash Benefit
Daily hospital cash benefit for an amount of Rs. 800 per day; maximum Rs. 4,800 for Base Sum Insured upto 15Lacs (or Rs. 1,000 per day; maximum Rs. 6,000 for Base Sum Insured more than 15Lacs) will be provided if shared room accommodation is occupied in case of hospitalization in a network hospital. Minimum 48 hours of continuous hospitalization required, however claim would be paid from day one subject to hospitalization claim being admissible.
You can avail health checkup for Diagnostic Tests purposes from Day 1 for any insured person (including children), so that you live a healthier and happier life. You can choose tests from a pre-defined list up to a sub-limit as per the plan chosen. This benefit is available only once in a Policy Year and all tests must have been done on the same date.
We also cover the costs for availing a second medical opinion for which we have accepted a claim under In-patient or Day Care Treatment hospitalization. This benefit can be availed only once during a Policy Year.
Discount on renewal premium will be provided basis number of steps taken.
- Personal Accident Cover (Optional)
Personal Accident coverage can be opted for any adult insured against accidental death, permanent total and partial disability.
Daily hospital cash benefit will be provided for an amount based on the Base Sum Insured chosen,in case of hospitalization. Minimum 48 hours of continuous hospitalization required, however claim wouldbe paid from day one subject to hospitalization claim being admissible. Maximum coverage offered for 30 days/policy year/insured person.
Below benefits will be provided under this optional cover:
- Claim Safeguard: If We have accepted a Hospitalization claim, then the items which are not payable (please refer policy terms & conditions for the list) related to that particular claim will become payable.
- Booster Benefit Safeguard: No impact on Booster benefit if claim in a policy year is less than Rs. 50,000
- Sum Insured Safeguard: The Base Sum Insured will be increased on Cumulative Basis at each Policy Year on the basis of Consumer Price index (CPI) inflation rate in previous year published by the Central Statistical Organisation (CSO).
Premium will be based on your city of residence.
- Entry Age and family coverage
The entry age for adults under this policy can be from 18 to 65 years. The entry age for dependent children is from 91 days to 30 years in a family floater policy.
In an Individual cover, maximum up to 6 members (maximum of 4 adults and a maximum of 5 children) can be included in a single policy. Whereas, Family floater cover is available for maximum of 2 Adults and 4 children. Relationship allowed for adults is / are self, spouse, father, father in law, mother or mother in law.
Save tax under Section 80D of the Income Tax Act when you buy a Niva Bupa health insurance policy. Tax benefits are subject to changes in the tax laws, please consult your tax advisor for more details.
- Assured Policy Renewal for Life
Once insured with us, you will always remain our customers subject to continued payment of premium. We assure you renewability for life with no extra loadings based on your claim history.
We believe you should focus on the treatment of your loved ones rather than running after claim settlement. Therefore, all claims are processed directly by our customer service team.
Cashless Facility can be availed only at our Network Providers or Service Providers. Please contact us for more details.
We endeavor for transparency and complete satisfaction and therefore, our policies are transparent and easy to understand. If you are not satisfied, we provide a 15-day free look period (30 days if the Policy with Policy Period as 3 years has been sold through distance marketing)within which you can cancel your plan stating the reason.
- Information at your fingertips
Get quick and easy access to your claims history, your health information, your health profile, including records of tests and other details on our website.